Frequently Asked Questions
There is a great deal of scientific information linking various nutritional factors to the onset and progression of MS. Many of these nutritional issues related to MS can be readily addressed and resolved by the strategies discussed on this website. Notably, many people have had great success in keeping MS well controlled by using the recommended, science-based, nutritional strategies.
The length of time between starting the use of nutritional strategies and seeing positive benefits greatly varies from person to person. Many have reported obvious benefits within a month whereas others have had to wait between 6 months and a year.
Dairy products contain proteins that activate myelin-sensitive immune cells and thus any consumption of dairy products helps to drive the MS disease process. All dairy products from milk to cheese to yogurt to butter, and including those from goats, must be completely avoided at all times. Any “cheating” on this can be very problematic. There are a number of good substitutes for dairy products available. I might note that when I go to a restaurant is I always tell the waiter I have allergies and that it is most important that my meal be completely free of dairy and gluten.
The biggest reason gluten is a major problem for MS is that it contains a protein called zonulin. This protein opens up both the intestinal barrier and the blood-brain barrier and the failure of these barriers is a key part of the MS disease process. The complete avoidance of gluten at all times is essential. Notably, a number of neurological problems are directly related to gluten ingestion.
A variety of scientific studies have shown that excess sodium contributes to the MS disease process. The best way to avoid excess sodium is to limit sodium intake to less than 1 gram (1000 mg) a day (average Canadian intake is 3500 mg/d). This will entail reducing salt intake as much as possible. Most products have sodium content listed on the package and it is important to avoid products with excessive sodium.
One wants to maintain a blood level of vitamin D of 100 – 150 nmol/l (40-60 ng/ml) to ensure all systems have access to required vitamin D. A daily supplement of 4000 – 6000 IU of vitamin D3 should be sufficient for most people and the cost is less than a dime a day.
There are four different types of fat with two being potentially problematic and two being of help. There is solid scientific evidence that excess saturated fat and omega 6 fat contribute to MS worsening. Monounsaturated fat and omega 3 fat are beneficial for MS. The key to fat intake is a balance of the four fat types. For a reasonable intake of 80 grams of fat a day, 40 g of monounsaturated (olive oil best), 20 g of saturated, 13 g of omega 6, and 7 g of omega 3 (fish oil mainly) is an ideal balance.
It is important to combat excess oxidation which is part of the MS inflammatory process. Most persons with MS have been shown to be deficient in anti-oxidants. The best way to ensure adequate anti-oxidants is to consume lots of vegetables and fruits, the more the better. Anti-oxidant supplements also can help and a list of such supplements is provided on the supplement page.
Research has demonstrated that adverse elements in the gut flora are part of the MS disease process by way of altering immune responses and increasing gut wall permeability. Our nutritional recommendations, which include pre-biotics and probiotic supplements, will ensure a healthy gut flora is established and maintained.
Numerous studies have shown that exercise is beneficial for MS and each person should develop an exercise program that fits their personal situation. Swimming is one of the best exercises for all around benefits.
There is solid science linking the biochemical changes associated with stress to adverse immune reactions which are part of the MS disease process. Thus, stress reduction techniques can be of significant value to help keep MS well controlled. Some of the commonly used techniques include getting adequate sleep, meditation, and relaxation exercises. A google search will provide numerous suggestions for managing and reducing stress.
Given there is a genetic component of MS, anyone with a family member with MS should definitely look at ways to reduce the risk of MS. The easiest way to prevent MS is to ensure adequate vitamin D (4000 – 6000 IU/d) (1000 – 4000 IU for children) and to use other nutritional strategies such as the avoidance of dairy and gluten. Ensuring a healthy gut flora would also greatly lessen the chance of developing MS.
Canada and Scotland have the highest rates of MS and the reasons for this are clear. Both countries have a perfect storm of key MS risk factors including a very low intake of vitamin D due to their northerly location, high intake of dairy and gluten, low intake of omega 3 fat, and a high intake of saturated fat and sodium. All these nutritional risk factors, combined with a genetically susceptible population and hygienic conditions, produces by far the highest rates of MS in the world.
Currently there is no solid scientific evidence that any of the current MS drugs significantly slow MS progression over the long term. The science to demonstrate long term value would require long term clinical trials with relevant outcomes such as time to a specific disability level. Such trials have never been attempted.
Although there is no strong evidence the drugs have any significant effect on long term progression, they do have some anti-inflammatory value. Overall an MS drug can be viewed as one more supplement which helps to control the MS disease process. Most of the drugs come with both short term and long term adverse side effects. Each person must decide for themselves if they want to include an MS drug in their arsenal to fight MS.
If one is using the recommended nutritional therapies and an MS drug and progression is continuing, then a drastic measure may well be required to slow or halt the MS disease process. The current literature indicates that an autologous haematopoietic stem cell transplant may be the best option to significantly slow the MS disease process. Clearly, all potential options would have to be discussed with a neurologist before any decision is made.
Research has demonstrated beyond a reasonable doubt that impaired blood flow from the brain (CCSVI) is strongly associated with MS. Theoretically, such impaired blood flow can contribute to the MS disease process mainly by weakening the blood-brain barrier. Thus, it may well be worthwhile to be checked for impaired blood flow and have it restored. Unfortunately, recent clinical trials have shown that venous angioplasty often does not restore blood flow for longer than a few months and consequently is not an effective treatment for the problem in many cases. In summary, there is no clear answer to this question and hopefully future research will result in the development of an effective treatment for impaired blood flow from the brain.